1. Postexercise reflex facilitation in Lambert-Eaton myasthenic syndrome.
- Author
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Poh, Mervyn, Yeo Chong Ming, Cheong Yanni, Patricia, Gee Jin Ng, Yong Howe Ho, Prasad, Kalpana, and Thirugnanam, Umapathi
- Subjects
BLADDER tumors ,REFLEXES ,LAMBERT-Eaton myasthenic syndrome ,FATIGUE (Physiology) ,MYASTHENIA gravis ,IMMUNOGLOBULINS ,MUSCLE weakness ,NEUROENDOCRINE tumors ,EXERCISE tests ,BIOLOGICAL assay ,DIPLOPIA - Abstract
A 62-year-old woman had 6 months of proximal weakness, fatigue and occasional diplopia, symptoms normally suggesting myasthenia gravis or inflammatory myopathy. Postexercise reflex facilitation is a bedside clinical sign that points to a diagnosis of the rarer alternative, Lambert-Eaton myasthenic syndrome (LEMS). We confirmed this diagnosis using electrodiagnostic short exercise testing and serum assay for voltage-gated calcium channel antibodies. Further investigation identified a small cell neuroendocrine carcinoma of the gallbladder, not previously associated with LEMS. Postexercise reflex facilitation is an important bedside clinical finding that helps clinicians to distinguish LEMS from its mimics. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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